Silver Diamine Fluoride (SDF)

What is Silver Diamine Fluoride?

Silver Diamine Fluoride is an FDA-approved antibiotic liquid clinically applied to control active dental caries and prevent further progression of disease. While the ideal way to treat teeth with decay is by removing the decay and placing a restoration, this alternative treatment allows us to stop decay with noninvasive methods, particularly with young children that have baby teeth who would be unable to complete typical treatment.

Treatment with Silver Diamine Fluoride will not eliminate the need for restorative dentistry to repair function or aesthetics but has been effective at prevention of further decay. Dental restorations may include but are not limited to dental fillings, root canal therapy and or crowns.

How does Silver Diamine Fluoride work?

Silver Diamine Fluoride is composed of two primary components: silver and fluoride. Silver acts as an anti-microbial agent that simultaneously strengthens the underlying protective layer of your teeth called dentin. Fluoride is the active ingredient that puts a stop to tooth decay and helps prevent additional decay from appearing.

When is Silver Diamine Fluoride recommended?

There are several situations in which it may be recommended. Those include, but are not limited to the following:

• Children who may have excessive decay (severe early childhood caries)
• Young children who have difficulty cooperating for treatment
• Special needs patients
• Children with carious lesions that may not all be treated in one visit

Facts for consideration:

• Silver diamine fluoride (SDF) is an antibacterial liquid used to treat tooth sensitivity and to help stop tooth decay. SDF may require repeated application.
• The procedure:
• Dry the affected area.
• Place a small amount of SDF on the affected area.
• Allow the SDF to dry.
• Rinse.
• Child should not be treated with SDF if:
• Your child is allergic to silver.
• There are painful sores or raw areas on my gums (i.e., ulcerative gingivitis) or anywhere in my mouth (i.e., stomatitis).
• Treatment with SDF does not eliminate the need for dental fillings or crowns to repair function or esthetics. Additional procedures will incur a separate fee.

Benefits of receiving SDF:

• SDF can help stop tooth decay.
• SDF can help relieve sensitivity.
• SDF can help buy time for those patients who are very young, fearful, or have special needs that may otherwise require sedation for traditional dental treatment.

Risks related to SDF include, but are not limited to:

• The affected area will stain black permanently. Healthy tooth structure will not stain. Stained tooth structure can be replaced with a filling or crown in the future.
• If accidentally applied to the skin or gums, a brown or white stain may appear that causes no harm and will disappear in one to three weeks.
• Your child may notice a metallic taste that will go away rapidly.
• There is a risk that the procedure will not stop the decay and no guarantee of success is granted or implied.
• If tooth decay is not arrested, the decay will progress. In that case the tooth will require further treatment, such as repeat SDF, a filling or crown, root canal/pulp treatment or extraction.

Alternatives to SDF, not limited to the following:

• No treatment, which may lead to continued deterioration of tooth structures and cosmetic appearance. Symptoms may increase in severity.
• Depending on the location and extent of the tooth decay as well as the level of behavior and cooperation, other treatment may include placement of fluoride varnish, a filling or crown, extraction, with or without sedation.